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Ms. Jessica Richardson
102 Barbados Place
Stephens city, VA 22655
(540) 877-6954

Current Inspector: Beth Orebaugh (540) 847-9173

Inspection Date: Aug. 23, 2019

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Household Members
22VAC40-111 Physical Health of Caregivers and Household Members
22VAC40-111 Caregiver Training
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Care of Children
22VAC40-111 Preventing the Spread of Disease
22VAC40-111 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
22VAC40-80 THE LICENSING PROCESS.
22VAC40-191 Background Checks for Child Welfare Agencies
54.1-3408 Provider must be MAT certified to administer prescription medication.
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs

Technical Assistance:
We discussed the requirements for documenting emergency drills, annual training, and children's records. The risk assessments for violations were provided.

We talked about making sure surfaces, such as door knobs/gates, are not handled on the way to the hand sink after each diaper change.

A vaccine is due for a pet by September 1, 2019.

Comments:
Thank you for your assistance during today's unannounced monitoring inspection conducted from 12:20 PM to 4:55 PM. Today, there were five to seven nonresidential children in care and two resident children under age eight years with the provider. The provider scheduled attendance to ensure she had sixteen points while alone. I viewed daily routines, equipment, activities, nap, snack, posted information, diapering procedures, pet record, emergency supplies and drill record, five records for children, three caregiver/resident records, caregiver training, indoor and outdoor areas. The provider has ensured supervision of the children during rest time. A variety of age appropriate toys and equipment were accessible for the children in care. We discussed options for using reminder systems so that needed records are obtained in a timely manner. Also, consistency with use of storage systems for records was recommended.

Let me know if you need any assistance. 540/430-9259

Violations:
Standard #: 22VAC40-111-830-C
Description: Based on a review of emergency evacuation drills, and an interview with the provider, the provider failed to ensure that the documentation of all emergency drills conducted in 2019 was maintained as required. Evidence: The form with the monthly evacuation drills had information up to March 4, 2019. The provider indicated that monthly evacuations have been practiced and not written on this form. The provider said another form may have been started and it was not located for review.

Plan of Correction: The provider will make sure all emergency drills are documented at the time of the drill and the form is kept in a consistent location so that it can be easily used and reviewed.

Standard #: 22VAC40-111-100-A
Description: Based on a review of five records for children, and an interview with the provider, the provider did not ensure that documentation of a physical examination was obtained for all children either prior to attendance or within thirty days after the first day of attendance. Evidence: Child 2 enrolled on April 1, 2019 and there was only immunization information in the record.

Plan of Correction: The provider is contacting the parent this date and will obtain a copy of the physical examination report for child 2. A tracking system will be used for new children's records such as the check list and a calendar reminder for due dates.

Standard #: 22VAC40-111-110-B
Description: Based on a review of five records for children, and an interview with the provider, the initial immunization record for a child was not signed by a physician or the physician's designee. Evidence: Child 3 began attending August 6, 2019 immunization report was printed by the parent using "My Chart" on October 19, 2018. It was not a report from a health care provider containing the required signature.

Plan of Correction: The provider requested an immunization record that is signed by the health care provider. The provider will review all records provided by parents and make sure they include all required information. Parents will be told the medicatl records must be obtained from the health care provider's office.

Standard #: 22VAC40-111-60-B
Description: Based on a review of five records for children, and an interview with the provider, the provider failed to obtain all required information for children's records. Evidence: There was not complete information for two emergency contacts in the record of child 1. There was only one name and address and no phone number listed on the registration form. The section for the second section for listing another emergency contact was left blank.

Plan of Correction: During pick-up, the provider will obtain the phone number for the first emergency contact listed and complete contact information for a second person. The provider will review all records at the time children enroll and make sure they contain all required information. The parents will be told in advance of the need to provide two emergency contacts.

Standard #: 22VAC40-111-70-A
Description: Based on a review of five records for children, and an interview with the provider, the provider failed to provide all required operating information to parents before the first date of attendance for all children in care. Evidence: There was not a copy of the written information regarding provisions of the family day home's emergency preparedness and response plan signed by parents on a the model form for the record of child 1 who began attending August 19, 2019, child 2 who began attending on April 1, 2019 and child 5 who started on June 11, 2019.

Plan of Correction: The provider will give the three parents copies of the form with information about the provisions for the the emergency response procedures and obtain signatures. The provider will keep track of all information submitted and obtained for the children's records.

Standard #: 22VAC40-111-210-A
Description: Based on a review of training for two caregivers, and an interview with the provider, the provider did not ensure that all caregivers obtained at least sixteen hours of annual training. Evidence: According to the certificates in the file, caregiver 1 completed only six hours of training between April 2018 and April 2019.

Plan of Correction: Annual training for the coming year was started in May 2019. The provider will track training hours and make sure a minimum of sixteen hours are completed as required. A reminder system for due dates will be used.

Disclaimer:
A compliance history is in no way a rating for a facility.

The online compliance history includes only information after July 1, 2003. In addition, the online compliance history includes information regarding adverse actions that may be the subject of a pending appeal. An adverse action is not final until a provider has exhausted or waived all due process rights. For compliance history prior to July 1, 2003, or information regarding the status of pending adverse actions, please contact the Licensing Inspector listed in the facility's information. The Virginia Department of Social Services (VDSS) is not responsible for any errors in or omissions from the compliance history information.

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